Comparing the Effect of Herbal Drugs and Non-steroidal Anti-Inflammatory Drugs on Primary Dysmenorrhea in Iran: a Systematic Review and Meta-Analysis

Several studies have been conducted to investigate the effects of herbal drugs and Non-steroidal anti-inflammatory drugs on the primary dysmenorrhea, but their results have been different.The aim of this study was to compare the effects of herbal drugs and NSAIDon the primary dysmenorrheausing meta-analysis method.A literature search was conducted in Scopus, Pub med, and Google scholar databases from1996 to December 2016 in English and Persian languages using the search keywordsof primary dysmenorrhea combined with herbal and NSAID. The random effect model was adoptedto combine the results of the studies, and I2 index was used to check heterogeneity. One hundred and ninety-nine studies were obtained, and after reading the abstracts, 21 articles were included in the study. The total number of samples was 2041 people. The standard mean difference(SMD)betweenherbal drugs and Non-steroidal anti-inflammatory drugs in the pain reduction in the first intervention was estimated atSMD= 0.2(95%CI:(-0.340.74 ),  z=0.73, p=0.463), and in second intervention it was SMD=-0.59(95%CI: (-1.650.47),Z=1.09 and p=0.278). also, the SMD for the duration of menstrual variable SMD=0.18(95%CI:( 0.02 0.34) , z=2.20, p=0.027) in favor of NSAID drugs and interval cycle of menstrual variable was SMD=0.07(95%CI:(-0.140.28), z=0.68,  p=0.496).Mean difference of pain intensity reduced relatively better by administering herbal medicines, which is supported by the majority of studies, and the herbal drugs were found to be more effective than the NSAIDs drugs. Finally, given the many side effects of non-steroidal anti-inflammatory drugs, herbal drugs can be used at the standard dosageand considering the side effects.